tbuckley/cabot-search huggingface dataset:
POS0670 DIAGNOSTIC DELAY IS ASSOCIATED WITH WORSE OUTCOMES IN TERMS OF STRUCTURAL DAMAGE IN PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS. RESULTS FROM REGISPONSER-AS
Authors: M. L. Ladehesa Pineda, M. Á. Puche Larrubia, F. U. Pilar, A. Escudero Contreras, E. Collantes Estevez, C. López-Medina
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Diagnostic delay in axial Spondyloarthritis (axSpA) is longer than in many other rheumatic diseases. It has been demonstrated to be associated with socioeconomic factors, disease presentation <sup>[1]</sup>, HLA-B27 negativity, female sex, psoriasis and younger age at onset <sup>[2]</sup>. Prolonged delay is associated with poorer long-term outcomes, including functional impairment and quality of life. <h3>Objectives</h3> To evaluate whether diagnostic delay in patients with radiographic axSpA (r-axSpA) is associated with poorer short-term outcomes after two years of follow-up. <h3>Methods</h3> Observational, longitudinal and prospective study including patients from the REGISPONSER-AS study (Spondyloarthritis Registry of the Spanish Rheumatology) with a diagnosis of r-axSpA according to the modified NY criteria. At baseline, the patients were divided into two groups according to the median of diagnosis delay (&lt;5 years, ≥5 years). Binary logistic regression models adjusted for disease duration were constructed to evaluate the association between the diagnosis delay and disease outcomes at two years. The retention rate of the first anti-TNF treatment across the groups was evaluated using a log-rank test. <h3>Results</h3> A total of 729 patients were included. Outcomes at two years according to diagnosis delay are presented in the Table 1. Characteristics related with structural chronic damage (BASRI, occiput wall distance), inflammatory bowel disease (IBD), dactylitis, SF-12 mental component and inability to work were associated with longer diagnosis delay. No differences were found in the retention rate of the first anti-TNF antibody between the groups. <h3>Conclusion</h3> Diagnostic delay is associated with poorer short-term outcomes in terms of structural damage, prevalence of IBD, dactylitis, SF-12 mental component and inability to work in patients with r-axSpA. <h3>References</h3> [1]Zhao SS et al. Diagnostic delay in axial spondyloarthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2021;60(4):1620-1628. [2]Redeker I et al. Determinants of diagnostic delay in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data. Rheumatology (Oxford). 2019;58(9):1634-1638. <h3>Acknowledgements</h3> Thanks to all the patients and investigators from REGISPONSER. <h3>Disclosure of Interests</h3> None Declared.
POS0435 PEPTIDE-BASED VACCINE TARGETING IL17A ATTENUATES EXPERIMENTAL SPONDYLOARTHRITIS INHLA-B27 TRANSGENIC RATS
Authors: H. Hayashi, J. Sun, H. Nakagami, T. Tomita
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing spondylitis (AS) is one of the major diseases in spondyloarthritis (SpA). HLA-B27 is known as a genetic risk factor for AS. Recent lines of evidence suggests that IL-23/IL-17 axis strongly contributes to AS. <h3>Objectives</h3> This study was to assess the efficacy of IL17A peptide-based vaccine on the SpA manifestations in model rat. <h3>Methods</h3> HLA-B27/human beta 2 -microglobulin transgenic rats were immunized with heat-inactivated Mycobacterium Tuberculosis (MT) to develop spondylitis and arthritis as an experimental spondyloarthritis model after 3 times immunization with KLH-conjugated IL17A peptide-based vaccine with alum adjuvant. IL17A antibody titer was assessed by ELISA, and arthritis score and joint thickness was monitored twice a week. At 9 weeks, joints of ankle and spine were collected to analyzed by histological analysis and realtime PCR for evaluation of inflammation and bone remodeling. Moreover, heart, liver, and lung were also collected for safety assessment by HE staining. <h3>Results</h3> IL17A peptide-based vaccine with alum adjuvant successfully induced antibody production, and suppressed arthritis score and joint thickness. X-ray and histological analysis showed that enthesitis, bone destruction, and new bone formation were inhibited by IL-17A vaccine. Moreover, SpA-induced expression of IL17A-related inflammatory- and bone remodeling molecules were down-regulated in the ankle and spine. Finally, IL-17A vaccine had no tissue damage by histological analysis. <h3>Conclusion</h3> These data showed that peptide-based vaccine targeting IL-17A prevented SpA phenotype in heat-inactivated Mycobacterium Tuberculosis-induced SpA model in HLA-B27/human beta 2 microglobulin transgenic rats. IL17A-peptide based vaccine can be a therapeutic option for SpA treatment. <h3>References</h3> [1]Nakagami H, Morishita R: Recent Advances in Therapeutic Vaccines to Treat Hypertension. Hypertension 2018, 72(5):1031-1036. [2]Nakagami F, Koriyama H, Nakagami H, Osako MK, Shimamura M, Kyutoku M, Miyake T, Katsuya T, Rakugi H, Morishita R: Decrease in blood pressure and regression of cardiovascular complications by angiotensin II vaccine in mice. PLoS One 2013, 8(3):e60493. <h3>Acknowledgements</h3> This work was supported by a grant from the Japan Agency for Medical Research and Development 20ek0109312h0003 and 22ek0109565h0002. <h3>Disclosure of Interests</h3> None Declared.
POS0836 RISK OF INFECTIONS BETWEEN JAK INHIBITORS AND TNF INHIBITORS AMONG PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: S. R. Choi, A. Shin, Y. J. Ha, Y. J. Lee, E. B. Lee, E. H. Kang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> With the increasing number of treatment options for rheumatoid arthritis (RA), safety is one of the important consideration for decision-making. <h3>Objectives</h3> To compare infectious risk between JAK inhibitors (JAKi) versus TNF inhibitors (TNFi) among patients with RA in Korea. <h3>Methods</h3> Using 2009-2019 Korea National Health Insurance Service database, we conducted a cohort study on RA patients initiating JAKi or TNFi. The outcomes of interest were 1) serious bacterial, 2) opportunistic, and 3) herpes zoster infections. Propensity-score fine-stratification (PSS) based weighting was applied to adjust for &gt;60 baseline covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models comparing JAKi versus TNFi users. <h3>Results</h3> Among 2,967 JAKi initiators and 13,152 TNFi initiators, 2,963 JAKi initiators PSS-weighted on 5,169 TNFi initiators were included. During a mean follow-up of 1.16 years, the most frequent type of infections was herpes zoster with an incidence rate (IR) per 100 person-years of 11.54 and 4.88 in JAKi and TNFi users, respectively, followed by serious bacterial infections with an IR of 1.39 and 1.32, respectively. The opportunistic infection was rare with a majority being tuberculosis, and showed an IR of 0.12 and 0.49 in JAKi and TNFi users, respectively. The PSS-weighted HR [95% CI] for individual types of infections was 2.37 [2.00-2.80] for herpes zoster, 1.04 [0.71-1.52] for serious bacterial infections, and 0.25 [0.09-0.73] for opportunistic infections, comparing JAKi to TNFi initiators. The risk of hospitalized herpes zoster was even higher among JAKi than TNFi initiators with a HR of 7.43 [3.91-14.11]. <h3>Conclusion</h3> In this nationally-representative cohort study on RA patients, we found an exceptionally high IR of herpes zoster among JAKi initiators in Korea, showing a doubled risk compared to that in TNFi initiators. Although the risk of serious bacterial infections was comparable between the two treatment groups, the risk of opportunistic infections, particularly tuberculosis, was less among JAKi than TNFi initiators. <h3>Reference</h3> [1]Smolen JS, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685-99. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0809 HARNESSING CELL ENERGY METABOLISM TO SUPPRESS SALIVARY GLAND INFLAMMATION IN SJÖGREN SYNDROME
Authors: S. Colafrancesco, C. Barbati, D. Stefanoni, G. Buoncuore, R. Izzo, F. Giardina, A. Gattamelata, C. Alessandri, F. Conti, R. Priori
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> SG epithelial cells (SGEC) play a key role in sustaining inflammation in Sjӧgren Syndrome (SS), which is indeed termed an 'autoimmune epithelitis'. However, the mechanisms responsible for the inflammatory activation of SGEC remain largely undetermined. Our line of research indicates that SGECs in SS exhibit profound changes in cell energy metabolism as indicated by aberrant expression of autophagy [1]. Inhibitions of autophagic process results in a down regulation of SGECs activation [1], thus indicating a crucial role of SGEC energy metabolism in the induction of autoimmune epithelitis. <h3>Objectives</h3> Aim of this study is to characterize metabolic changes occurring in SS SGECs and dissect the link between these changes and their acquired pro-inflammatory function. <h3>Methods</h3> SGECs were isolated from minor SG biopsies deriving from patients with SS and sicca. Intracellular metabolomic analysis was performed on direct ex vivo isolated primary SGECs. As read out of functional activation of SS SGECs, supernatants from SGECs coltures were collected to perform ELISA test in order to evaluate the expression of the pro-inflammatory mediator IL-6. <h3>Results</h3> Principal component analysis (PCA) of high-throughput metabolomics analysis of sicca (n=7) and SS (n=7) SGECs revealed a separation along the component 1 axis (46.6% of variance) indicating profound differences in the intracellular metabolome (<b>Figure 1a</b>). Unsupervised clustering analysis of metabolites revealed profound metabolic differences between SS and (n=7) sicca (n=7) SGECs (<b>Figure 1b</b>). Analysis of selected metabolites confirmed a shift towards increased glycolysis and TCA cycle activation in SS SGECs (<b>Figure 1c</b>). Supernatant concentrations of IL-6 were higher in SS (n=21) compared to sicca (n=14) SGECs (<b>Figure 1d</b>). <h3>Conclusion</h3> SGECs from SS patients display altered cell energy metabolism with evidence of increased glycolysis and activated TCA cycle. A metabolic driven pro-inflammatory status of SS SGECs seems confirmed by increased basal expression of IL-6. Validation of our metabolomic results, along with transcriptomic and epigenetic studies, is currently ongoing in SGECs from SS and sicca to dissect the link between changes in cell energy metabolism and their acquired pro-inflammatory phenotype. <h3>Reference</h3> [1]Colafrancesco S, et al. Maladaptive Autophagy in the Pathogenesis of Autoimmune Epithelitis in Sjögren's Syndrome. Arthritis Rheumatol. 2022;74(4):654-664. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0478 FACTORS ASSOCIATED WITH PERSISTENTLY HIGH HAQ-DI SCORE IN RA PATIENTS UNDER B/TSDMARDS: LONGITUDINAL ANALYSIS OF HURBIO SINGLE CENTER REGISTRY
Authors: E. Bilgin, E. Öztürk, B. Firlatan, M. Ekici, G. S. Kart Bayram, E. Unaldi, G. Ayan, G. Sandal Uzun, Z. Özsoy, S. A. Germe, B. Farisogullari, L. Kiliç, A. Akdoğan, O. Karadag, Ş. A. Bilgen, A. İ. Ertenli, P. Özdemir, U. Kalyoncu, S. Kiraz
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Health Assessment Questionnaire-Disability Index (HAQ-DI) is a widely-used and accepted instrument for the functional assessment of rheumatoid arthritis (RA) patients. <h3>Objectives</h3> Our aim was to determine the related factors with persistently high HAQ-DI scores in RA patients using b/tsDMARDS. <h3>Methods</h3> RA patients prescribed with b/tsDMARds, registered to Hacettepe University Biologic Registry (HURBIO), had HAQ-DI score ≥1 at baseline assessment and had at least five follow-up visits, were grouped into 3, hypothetically, according to HAQ-DI scores at each of the first five follow-up visit. Group 1 was ''persistently-low HAQ-DI score &lt;1'' and had HAQ-DI score lower than one at each visit; group 2 was ''floating HAQ around 1'' who had at least one visit HAQ-DI score above one and HAQ-DI score below 1; group 3 was ''persistently-high HAQ-DI score &lt;1'' who had HAQ-DI score higher than one at each visit. Baseline demographic, disease, and treatment characteristics were recorded. Multinomial logistic regression for females and multiple logistic regression for males (as group 3 had no males) was done to reveal associated factors. <h3>Results</h3> A total of 194 patients (89.7% female) were included. Groups 1,2, and 3 consisted of 58 (29.9%), 111 (57.2%), and 25 (12.9%) patients. All patients in group 3 were female. RA disease duration, the time between RA diagnosis and b/tsDMARD initiation, RF negativity, and baseline HAQ-DI score were higher in group 3 compared to other groups (<b>Table 1</b>). Multinomial logistic regression revealed several associated factors (OR, 95%CI) for females; • group 2 over group 1: <b>being obese (3.0 (1.4-6.4), p=0.004),</b> negative RF (0.5 (0.2-1.2), p=0.13), using non-anti-TNF (2.1 (0.9-4.8), p=0.07), diagnosis-treatment initiation duration (per 1 year) (1.0 (0.9-1.1), p=0.85) • group 3 over group 1: being obese (0.9 (0.3-3.0), p=0.88), <b>negative RF (5.2 (1.4-18.6), p=0.012</b>), <b>using non-anti-TNF (9.5 (1.8-52.6), p=0.009), diagnosis-treatment initiation duration (per 1 year) (1.1 (1.05-1.112), p=0.001</b>) • This model classified 61% of the patients correctly. <h3>Conclusion</h3> RA patients are still away from good functional status. According to the results of this study, clinicians should treat RA earlier and increase the sensitivity of management dynamics in RF-negative and obese patients. Whether anti-TNFs or non-anti-TNFs work better on functionality should be interpreted cautiously, even if it remained statistically significant in the multivariable model. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0391 INCREASED RISK OF OSTEOPOROSIS AND HEAD OF FEMUR FRACTURES IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER - A LARGE RETROSPECTIVE COHORT STUDY
Authors: Y. S. Patt, N. Ben-Shabat, L. Fisher, K. Sharif, S. Lassman, A. Watad, H. Amital
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Chronic inflammatory conditions are characterized by an inflammatory milieu and increased exposure to glucocorticoids both resulting in increased risk of osteoporosis and subsequently bone fractures. Familial-Mediterranean-Fever (FMF) is a prototypical autoinflammatory disorder not treated with steroids. FMF association with osteoporosis and risk for femur fractures is not well evaluated. <h3>Objectives</h3> To evaluate the incidence of osteoporosis and head of femur fractures in FMF patients compared to the general population. <h3>Methods</h3> A retrospective cohort study using the electronic database of Clalit Health Services (CHS), the largest health organization in Israel. All FMF patients diagnosed between 2000-2016 were included with age-, sex- matched controls in 1:1 ratio. Follow-up continued until the first diagnosis of osteoporosis or femur fracture. The incidence of these conditions was compared between the groups using univariate and multivariate models adjusting for cardiovascular risk-factors. <h3>Results</h3> 9,769 FMF patients were followed for a median period of 12.5 years. 304 FMF patients were diagnosed with osteoporosis compared to 191 controls, resulting in an incidence rate (per 10,000 persons-years) of 28.8 (95%CI 15.7-32.5), and 17.8 (95%CI 15.4-20.6) respectively, and a crude HR of 1.62 (95% CI 1.35-1.93;p&lt;0.001). Patients were diagnosed with osteoporosis at a considerably younger age than controls (60.1±12.4 vs 62.5±11.0 years; p=0.028). Regarding femur fractures, 56 FMF patients were diagnosed with the condition compared to 35 controls, resulting in an incidence rate (per 10,000 persons-years) of 5.3 (95%CI 4.0-6.9), and 3.3 (95%CI 2.3-4.6) respectively, and a crude HR of 1.60 (95% CI 1.05 to 2.44;p&lt;0.05). Predictors of osteoporosis or femur fractures among FMF patients included older age, Arab ethnicity, as well as North African origin. In contrast, obesity was considered a protective factor, while colchicine treatment did not significantly affect the risk of these outcomes. <h3>Conclusion</h3> FMF patients are at increased risk for osteoporosis and consequently femur fractures. <h3>References</h3> [1]Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet. 2011 Apr 9;377(9773):1276–87. [2]Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ. 1993;307(6914):1248–60. [3]Adeyemi A, Delhougne G. Incidence and Economic Burden of Intertrochanteric Fracture: A Medicare Claims Database Analysis. JBJS Open Access. 2019 Mar 3;4[1]. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0415 ADIPOCYTE-OSTEOBLAST CROSSTALK IN SUBCHONDRAL BONE MARROW: NEW THERAPEUTIC TARGET IN OSTEOARTHRITIS
Authors: L. Loisay, A. Antoniadis, T. Hügle, J. Geurts
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Subchondral sclerosis and bone marrow adipose tissue (BMAT) lesions are radiographic hallmarks of knee osteoarthritis (OA). Energy supply through lipolysis of bone marrow adipocytes (BMAd) has recently been established as a crucial mechanism to fuel bone regeneration and maintain bone mass during energy deficits. It is unknown whether subchondral BMAd may contribute to subchondral sclerosis in OA through a similar mechanism. <h3>Objectives</h3> The goal of this study was to determine whether BMAd-derived factors differed as a function of the extent of subchondral sclerosis and to evaluate effects of lipolysis-modulating treatments in a human knee OA explant model. <h3>Methods</h3> Non-sclerotic (NS) and sclerotic (SC) osteochondral tissue chips (<i>n</i>=48 each) were explanted from tibial plateaus and treated with an activator (forskolin) or inhibitor (pioglitazone, metformin) of lipolysis. Secreted free fatty acids (FFA), triglycerides (TGL), adiponectin, IL-6 and ALP activity were measured in supernatants. <h3>Results</h3> Adiponectin (1.6-fold), TGL (1.7-fold) and ALP activity (6.7-fold) levels were increased in SC compared with donor-matched NS tissues (<i>p</i>&lt;0.05). Interestingly, FFA (<i>r</i>=0.60) and adiponectin (<i>r</i>=0.76) were positively correlated with ALP activity (<i>p</i>&lt;0.01) in SC tissues only (Figure 1). Modulation of lipolysis affected secretion of FFA and TGL (<i>p</i>&lt;0.01), but not adiponectin, in NS tissues only. ALP activity remained unaffected by any treatment in NS or SC tissues. Metformin treatment reduced IL-6 secretion 4-fold (<i>p</i>&lt;0.05) in SC tissues. <h3>Conclusion</h3> Collectively these data support the new paradigm that BMAd-derived factors may play a previously unrecognized role in regulating pathological bone remodelling in human OA. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0645 REAL LIFE SAFETY AND SURVIVAL OF TARGETED THERAPIES IN ARTHRITIS PATIENTS OVER AGE OF 65
Authors: E. Grau García, P. Muñoz Martinez, L. Mas Sanchez, S. Leal Rodriguez, I. Martínez Cordellat, R. Negueroles Albuixech, J. E. Oller Rodríguez, F. Ortiz-Sanjuán, D. Ramos Castro, C. Riesco Barcena, A. M. Torrat Noves, E. Tovar-Sugrañes, E. Vicens Bernabeu, H. Charia, L. Gonzalez Puig, A. V. Huaylla Quispe, J. Ivorra Cortés, I. Cánovas Olmos, C. Nájera Herranz, J. A. Román Ivorra
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Prognosis for chronic inflammatory arthritis is drastically improved over previous decades and older patients are treated with targeted therapies (TTs) (biological or synthetic targeted therapies). Clinical trials provide mainly information about TTs in patients below the age of 65, so real-life studies are needed to provide more information about TTs in patients over 65 years of age. <h3>Objectives</h3> To compare clinical and therapeutic profile of arthritis patients undergoing TTs and to analyze safety and therapeutic survival according to different age groups. <h3>Methods</h3> We performed an observational cross-sectional study in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients, older than 40 years old, who started biological or anti-JAK therapy between 2000 and 2022 in the Rheumatology Department of HUP La Fe. A comparative analysis and a Kaplan-Meier survival analysis was performed. <h3>Results</h3> 938 patients (62% female) were included in the study, of which 20.3% are PsA, 55.6% RA and 24.1% AS, with a mean age at the beginning of treatment of 57 (10) years and a mean duration of treatment of 68 (64) months. Patients were classified according to the age at the beginning of treatment: 40-65 years and ≥ 65 years of age. 219 patients (23.3%) were over 65 years of age. In the Table 1 we show the comparative analysis between both groups. Higher proportion of arterial hypertension, diabetes mellitus and dislipemia in patients older than 65 years was observed. Using a logistic regression model, an association between conventional DMARD prescription and patients older than 65 years was found (P&lt;0.001), being the methotrexate the most used (44.8%). Anti-TNF therapy was the most extended treatment in both groups of patients, and an association between anti-IL6 therapy and older patients than 65 years was observed (P&lt;0.001). Previous TTs were more frequent in older patients (P=0.002) and treatment duration was lower in those patients (P&lt;0.001). Adverse events were more commonly found in patients older than 65 years as the reason to TT discontinue (P=0.008), being infections the more frequent. <h3>Conclusion</h3> The use of conventional DMARDs, adverse events as the reason of treatment suspension and lower therapeutic survival are more frequent in patients older than 65 years of age. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0448 IDENTIFICATION OF JOINT LOCATIONS IN AN EARLY RHEUMATOID ARTHRITIS COHORT AS A CHARACTERISTIC OF DISEASE SEVERITY AND RESPONSE TO METHOTREXATE, DATA FROM THE ERA-UCLOUVAIN BRUSSELS COHORT
Authors: L. Bricman, E. Sapart, T. Sokolova, A. Avramovska, P. Durez
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Early RA patients (ERA pts) often present with different areas of joint involvement, but limited data exist to identify which specific joint locations may be indicative of greater disease severity. <h3>Objectives</h3> This analysis investigated the baseline (BL) prevalence of swelling, tenderness and erosions in individual joint locations and their possible association with disease characteristics, prognostic factors and response to Methotrexate (MTX) in a cohort of ERA pts. <h3>Methods</h3> This analysis was based on data from the ERA UCLouvain Brussels cohort in which patients were included according the ACR/EULAR 2010 criteria and naïve to DMARDs. The physician assessed prevalence of BL individual swollen and tender joint status (present, absent) through a physical examination. The joint count includes 44 joints. Similarly, all patient and RA characteristics were collected. The association between BL swelling, tender, erosions and disease characteristics was investigated for each individual joint. Remission rates (DAS28-CRP &lt; 2.6) in patients treated only with MTX were assessed in order to analyze the correlation with BL joint location. <h3>Results</h3> BL location of each swollen, tender, or erosive joint (44 joints) is summarized in Table 1: <h3>Conclusion</h3> In our cohort of ERA naïve to DMARD, swelling was most present in wrist and hand joints (PIP 3 and 2). Erosions were most frequent in MTP joints and wrist. Clinical response to MTX was poorer in patients with swelling of the wrist and feet as well as erosion of the feet. Joint location could be an additional prognostic factor in ERA for severity and response to MTX suggesting more intensive therapy. <h3>Acknowledgements</h3> This work was supported by CAP48/RTBF. <h3>Disclosure of Interests</h3> None Declared.